Provider Demographics
NPI:1831164649
Name:PRESCOTT, SARAH E (DO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:157 CAPITOL ST
Mailing Address - Street 2:SPECIALTY CENTER
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-6231
Mailing Address - Country:US
Mailing Address - Phone:207-626-1936
Mailing Address - Fax:207-622-1029
Practice Address - Street 1:157 CAPITOL ST
Practice Address - Street 2:SPECIALTY CENTER
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6231
Practice Address - Country:US
Practice Address - Phone:207-626-1936
Practice Address - Fax:207-622-1029
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME01340207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME245960099Medicaid
ME010057029Medicare PIN
ME245960099Medicaid
MEF28439Medicare UPIN
MEMM430801Medicare PIN